Results of plate fixation for transcondylar fracture of the distal humerus: a rare pattern of fractures

BACKGROUND: The pattern of transcondylar fracture of the humerus is unique and the incidence rate is very low. Stable internal fixation may be difficult to achieve, and complications have been reported at a higher rate. The purpose was to report the outcomes of open reduction and internal fixation (ORIF) for transcondylar fractures of the humerus. METHODS: Seventeen patients were included between January 2014 and December 2017. ORIF was performed using anatomic distal humerus plates. Results were evaluated by range of motion, Mayo Elbow Performance Score (MEPS), and complications. We analyzed the results according to ulnar nerve transposition status and fixation pattern. RESULTS: The mean range of elbow motion was 117° flexion and 20° extension. The MEPS was excellent in 12, good in 3, fair in 1, and poor in 1. There were in total 5 cases of complications among 17 patients: 1 with nonunion, 1 with ulnar neuropathy, 2 with delayed union, and 1 with heterotopic ossification. The results according to ulna nerve transposition and fixation pattern showed no difference. CONCLUSIONS: For reliable and good results, rigid fixation using anatomic plates and appropriate immobilization of the fracture site are key factors in the treatment. In our case series, the overall outcome was good and there were 2 major complications. The ORIF using anatomic plates can be a reliable treatment option for transcondylar humeral fractures.